CMS Formulary

Displaying 91641-91650 of 1611142 results.
ID: 91641
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91642
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91643
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 91644
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91645
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91646
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 91647
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91648
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91649
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 977939
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 91650
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 977942
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30